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Magnetically Induced Rotating Rayleigh-Taylor Instability
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Appendiceal carcinoma associated with microsatellite instability.

Angélica Morales-Miranda1, Ismael Domínguez Rosado2, Carlos Chan Núñez2

  • 1Department of Reproductive Biology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City 14080, Mexico.

Molecular and Clinical Oncology
|May 5, 2018
PubMed
Summary

Microsatellite instability (MSI) in appendiceal cancer is rare but may predict a good response to chemotherapy. This case study highlights successful adjuvant chemotherapy (FOLFOX) in an MSI-positive appendiceal carcinoma patient.

Keywords:
appendiceal adenocarcinomamicrosatellite instabilityperitoneal metastasesprognosis

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Area of Science:

  • Oncology
  • Gastroenterology
  • Pathology

Background:

  • Microsatellite instability (MSI) is observed in approximately 15% of colorectal cancers (CRC) and is linked to distinct biological behaviors.
  • Appendiceal carcinoma is a rare malignancy, and its association with MSI and response to treatment is not well-documented.

Purpose of the Study:

  • To present a case of appendiceal carcinoma with MSI that demonstrated a favorable response to adjuvant chemotherapy.
  • To describe the clinical, pathological, and immunohistochemical characteristics of this specific case.
  • To explore the potential implications of MSI testing in appendiceal carcinomas for prognosis and treatment prediction.

Main Methods:

  • A 60-year-old male patient with symptoms of appendiceal malignancy underwent laparoscopic appendectomy.
  • Histopathological and immunohistochemical (IHC) analyses were performed to characterize the tumor, including MSI status.
  • Staging investigations included colonoscopy and CT scan, followed by right hemicolectomy and peritoneal debulking.
  • Adjuvant chemotherapy with the FOLFOX regimen was administered post-surgery.

Main Results:

  • Histopathology revealed moderately differentiated appendiceal adenocarcinoma with mucinous areas.
  • IHC analysis indicated MSI (negative for MLH1, MSH2, MSH6).
  • The patient presented with metastatic disease to the omentum, liver capsule, spleen, and peritoneum.
  • Following right hemicolectomy, peritoneal debulking, and 10 cycles of FOLFOX chemotherapy, the patient remained disease-free for 5 years.

Conclusions:

  • Appendiceal carcinoma associated with MSI can exhibit a positive response to adjuvant chemotherapy, similar to MSI-positive colorectal cancers.
  • Testing for MSI in appendiceal carcinomas may offer valuable prognostic information.
  • MSI status could potentially guide treatment decisions and predict chemotherapy response in appendiceal cancer.